HomeMy WebLinkAboutStreet Cut Permits 154 Oxford Drive (2) ------ -- ------- ----
1400174 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/16/2014 sz
GIS ID: 68100154 = FEE: 25.00
MUNIS APPLICATION# 201400770
EXPIRATION DATE: 06/16/2015
APPLICAl�L
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NAME: ADVANCED CONSTiICTI�N QDR
S 5 OXFORD DRIVE
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ADDRESS: 5 CHESTNUT HILL_6 '
IIORGAN JOANNA M&
STAFFORD SPRINGS 607 .
5;10&10RD DRIVE
OLIIVINDSOR,CT 06074
PHONE 860-519-8442 /
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WORK DESCRIPTION: INS i/
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APPLICANT AGREES TO FURNISH THE O CCU SO 1111i �IffAMQL r0__F I ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIII{SE � � �P�IE E9 OIIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Tim P RANT IV0L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 6F S( UUEV1 lI3SI T �w TE IT MANUAL.
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ISSUED BY DA ;,: ITED INSPECTED BY
6/16/20141:38PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0011 CONTRACTOR:A G yo.oaoj CCU VIS Af-
LOCATION: Dq'*\ e
TYPE OF WORK: �_<-I�I NZ
DATE INSP NEEDED: DATE INSP: i I ►
INSPECTED BY: (gym
WORK IN
PROGRESS: I)va"ZcA
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: a DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appi, No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �.c,� r ra l( ( n rl C, ioe n G(A e c n S�Phone No. �j �L f LJ n
Address of Firm fi C.}'N C--:ZJ ,3(At- h�\k ('OC- 2 t-�0���d(g p��tir, ��- Zip Code
Location of proposed work 5-c jq.g DK-
Describe fully nature of permit requested
Starting date Approx. time for completion S 4 '3
Call Before You Dig No. _ >i Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT BATCH AND`CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ !sf
Est. Patch Cost$
Est. Curb Replacement _ ft
° Est. Curb Unit Price$ /f}
Est.Curb Cost$
Est.Traffic Unit Cost$_ _____-_/hr
Est.Traffic Control$
Amt.of Deposit$
Total Due
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: P Mav 1
Date:
Title: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08